In a recent piece on radio station KGOU in Oklahoma, Jillian Taylor addressed the Wasteful and Inappropriate Service Reduction Model, or WISeR, a program being tested in six states, including Oklahoma, as of January this year. The program uses … [Read more...] about Oklahomans Concerned about Losing Care Under Model Medicare Prior Authorization Program
Weekly Alert
CMA Submits Comments Opposing Repeal of the Final Nurse Staffing Rule
The Center for Medicare Advocacy has submitted its comments strongly opposing the Centers for Medicare & Medicaid Services’ interim final rule with comment, entitled “Repeal of Minimum Staffing Standards for Long-Term Care Facilities,” … [Read more...] about CMA Submits Comments Opposing Repeal of the Final Nurse Staffing Rule
Know Jimmo | Medicare Covers Therapy in Nursing Homes to Maintain or Slow Decline
“Maintenance Therapy – Therapy services in connection with a maintenance program are considered skilled when they are so inherently complex that they can be safely and effectively performed only by, or under the supervision of, a qualified therapist. … [Read more...] about Know Jimmo | Medicare Covers Therapy in Nursing Homes to Maintain or Slow Decline
Video Resource from the Long Term Care Ombudsman Programs
A new film, Breaking the Silence, emphasizes the importance of long term care residents understanding their rights and the resources available to them. It is about understanding resident fear due to a perceived power imbalance and the potential for … [Read more...] about Video Resource from the Long Term Care Ombudsman Programs
CMA Co-Director Testifies in Support of Three Medicare-Related Bills
On January 8, 2026, Center for Medicare Advocacy Co-Director David Lipschutz appeared as an invited witness before the House Energy & Commerce Committee, Health Subcommittee at a hearing titled “Legislative Proposals to Support Patient Access to … [Read more...] about CMA Co-Director Testifies in Support of Three Medicare-Related Bills
Questioning your Medicare Advantage Plan Choice? Now is the Time to Act!
The Medicare Advantage Open Enrollment Period is January 1-March 31. During this limited time, Medicare beneficiaries can change Medicare Advantage plans or switch to Traditional Medicare. If you change to Traditional Medicare, you may also obtain a … [Read more...] about Questioning your Medicare Advantage Plan Choice? Now is the Time to Act!
Know Jimmo | Looking at You, AI – Rules of Thumb Should Not Be Used to Deny Medicare
To qualify for most Medicare-covered care, the individual must need and receive skilled care. Skilled services include nursing, physical therapy, occupational therapy, and speech-language pathology services. In November 2010, CMS revised its … [Read more...] about Know Jimmo | Looking at You, AI – Rules of Thumb Should Not Be Used to Deny Medicare
From Colorado – Medicare and Medicaid care changes in 2026
In "Insurance in 2026: Fed bill will result in coverage, rate changes; impacts felt locally" an article in the Crestone (CO) Eagle, reporter Jennifer Leonard highlights significant changes coming to Colorado health care in 2026, including citing the … [Read more...] about From Colorado – Medicare and Medicaid care changes in 2026
CMS Indefinitely Suspends Off-Cycle Medicare Revalidation Process for Nursing Homes
Private equity and real estate investment trusts have had a profoundly negative impact on the quality of care provided by nursing homes. Studies and articles have documented the lower staffing levels and increased deficiencies that follow these … [Read more...] about CMS Indefinitely Suspends Off-Cycle Medicare Revalidation Process for Nursing Homes
MA Options and Providers Decline in 2026 – MA Enrollees Can Make Changes Until March 31
The landscape of Medicare Advantage (MA) is changing in 2026. A number of large healthcare systems across the country have recently decided to terminate their MA contracts, which will leave many MA enrollees with fewer options for care. Some … [Read more...] about MA Options and Providers Decline in 2026 – MA Enrollees Can Make Changes Until March 31